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Coronary heart disease

• Overview
• Symptoms
• Treatment
• Prevention

Definition:

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease.

Alternative Names:

Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD

Causes, incidence, and risk factors:

Coronary heart disease is usually caused by a condition called atherosclerosis , which occurs when fatty material and a substance called plaque builds up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain ( stable angina ), shortness of breath, heart attack , and other symptoms.

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. According to the American Heart Association, more than 15 million people have some form of the condition.

Men in their 40s have a higher risk of CHD than women. But, as women get older, their risk increases so that it is almost equal to a man's risk. See: Heart disease and women

Many things increase your risk for CHD. Bad genes (heredity) can increase your risk. You're more likely to develop the condition if someone in your family has had it -- especially if they had it before age 50. Your risk for CHD goes up the older you get.

The following factors also increase your risk of CHD:

• Diabetes
• High blood pressure
• High LDL "bad" cholesterol
• Low HDL "good" cholesterol
• Menopause
• Not getting enough physical activity or exercise
• Obesity
• Smoking

Higher-than-normal levels of inflammation-related substances may also increase your risk for a heart attack. Such substances include C-reactive protein and fibrinogen . Increased levels of a chemical called homocysteine, an amino acid , are also linked to an increased risk of a heart attack.

References:

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation . 2007; Published online before print February 19, 2007.

Smith SC Jr, Allen J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation . 2006 May 16;113(19):2363-72. Erratum in: Circulation. 2006 Jun 6;113(22):e847.

Boden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med . 2007 Mar 26; [Epub ahead of print].

American Heart Association. Heart Disease and Stroke Statistics — 2007 Update . Dallas, Texas: American Heart Association; 2007.

• Review Date: 3/30/2007
• Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY, and Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network.

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